A study on lymph node metastasis in early gastric carcinoma / 中华普通外科杂志

ABSTRACT

Objective To study lymph node metastasis in early gastric carcinoma. Methods From July 2001 to July 2007, 177 patients with early gastric carcinoma underwent radical gastrectomy and the clinicopathologic data were analyzed by binary logistic regression. Results The overall rate of lymph node metastasis in early gastric carcinoma was 13%, involving 13% and 3% in level I (NI) and level Ⅱlymph nodes (N2), respectively. The rate of lymph node metastasis was 22%(20/89) in cases of submucosal lesion (SM), which was significantly higher than 3%(3/88) in cases of mucosal lesion (M) (X2=14. 222, P<0.01). The rate of lymph node metastasis was 3%(4/117) when the primary tumor was ≤2cmin diameter compared with 32%(19/60) when the tumor was >2cm (X2=27.992, P<0.01). The lymph node metastasis rate was 4%(3/81) and 21%(20/96) in differentiated and undifferentiated lesion (X2=11.402, P=0.001), and it was 33%(2/6)、8%(7/99) and 19% (14/92) in macroscopic type I, Ⅱ and Ⅲ (X2=8.172, P=0.014). Binarylogistic analysis found that the tumour diameter greater than 2.0cm (OR=8.408, P<0.01), infiltration of the submucosal layer (OR=5.926, P=0.009) and undifferentiated lesion (OR=4.880, P=0.020) were the independent risk factors. Conclusion Lymph node metastasis in early gastric carcinoma is significantly cantingent on the depth of infiltration, tumor size and histological type.